The Introduction To the Glossary of Chinese Medicine and Acupuncture Points

66 Pages·2006·0.29 MB·English

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The Introduction To
Glossary of Chinese Medical Terms and Acupuncture Points

Translated and Compiled By Nigel Wiseman with Ken Boss

Consulting translators
Paul Zmiewski
Andrew Ellis

Library of Congress number 89-2982

Copyright (C) 1990 Paradigm Publications
Copyright (C) 1995 Paradigm Publications

Paradigm Publications
44 Linden Street
Brookline, Massachusetts 02146 U.S.A.

All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system or transmitted in any form by any means,
electronic, mechanical, photocopying, recording or otherwise, without
the prior written permission of the publisher.

Permission is granted for individuals to make personal use of
this computer edition of this Introduction. It may be copied,
downloaded, or otherwise transferred providing that this copyright
notice be included entire and that no commercial consideration, fee
or exchange be required.

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Editor's Note

This edition differs from the published gloss. Lists of Chinese
characters have been removed. The typeset pinyin toning has
been replaced by a pre-press mark-up system that indicates
the tones. In this system numeral represent the four
Mandarin tones: 1 = the high, flat tone usually represented by a
solid
horizontal line over the accented vowel
2 = the rising tone usually represented by a
``right-
leaning'' accent (/)
3 = the deep, dipping tone usually represented by
the ``V'' (\/) accent.
4 = the high, falling tone usually represented by
the ``left-leaning'' (\) accent
In addition:
" = the umlaut in combination with the above tone,
e.g.: u4" is a ``u'' umulat of tone four.

The following table details the various combinations and the
order of interpolation:

ang1 ang2 ang3 ang4 ang5
an1 an2 an3 an4 an5
ao1 ao2 ao3 ao4 ao5
ai1 ai2 ai3 ai4 ai5
a1 a2 a3 a4 a5
eng1 eng2 eng3 eng4 eng5
en1 en2 en3 en4 en5
er1 er2 er3 er4 er5
ei1 ei2 ei3 ei4 ei5
e1 e2 e3 e4 e5
ing1 ing2 ing3 ing4 ing5
in1 in2 in3 in4 in5
ong1 ong2 ong3 ong4 ong5
ou1 ou2 ou3 ou4 ou5
o1 o2 o3 o4 o5
i1 i2 i3 i4 i5
un1 un2 un3 un4 un5
u1 u2 u3 u4 u5
u1" u2" u3" u4"
ui1 ui2 ui3 ui4 ui5
ue1" ue2" ue3" ue4"

``[ ]'' surrounds footnote numbers, footnotes will be found at the
end of the text.

In the Notes Chinese characters have been replaced by one ``X''
for each character. These were generally a character reference
to the term discussed.

The text relating only to the use of the text in which this
introduction appeared has been expunged.

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Introduction

Extant texts of Chinese medicine in Chinese are estimated to
number more than 12,000.[1] Yet no more than 200 are available
in English at the present time.[2] Of these, only a small
percentage have been translated directly from Chinese sources.
Of that small percentage, few reveal the rigorous translation
standards that are necessary to guarantee the conceptual
integrity and clinical validity of Chinese medicine in
English.[3] Any cursory review of English language books shows
striking differences in terminology that hamper the
understanding of even basic concepts, and forestall the Chinese
medical community's advance to a deeper knowledge of the
discipline. All signs point to the conclusion that the
transmission of Chinese medicine to the West is still in its
infancy.

For Chinese medicine, the most important period of
transmission began in the 1960's, when acupuncture started to
develop as a profession in the West. This period followed one
of the greatest changes Chinese medicine had ever undergone:
its adaptation to the twentieth century.[4]

Western influence, which finally brought about the collapse
of Imperial China in 1911, ushered in a new era for Chinese
medicine. Traditional healing was spared by the nationalists
after the founding of the Republic, and was again spared by the
communists after 1950, in part because of the lack of Western
medical practitioners, and in part by the purported similarity
of Chinese medical theory to marxist ideology.[5] Although it
survived, its name yi1 or yi1 xue2 (medicine)[6] was changed to
zhong1 yi1 (Chinese medicine),[7] reflecting its declining
status relative to its Western rival. After World War II when
it was incorporated by the Chinese government into a modern
mass health-care system, it underwent a thorough revision.
Mass health care demanded unified standards of practice, and a
unified method of teaching in colleges. The traditional medley
of different schools of thought and heterogeneous practices,
many of which bordered on shamanism, were unified into a more
coherent system, and superstitious elements were expunged.[8]
Traditional transmission by individual healers to their
apprentices, with its emphasis on memorization of the classics
and mnemonic verses, was replaced by efficient modern classroom
methods of mass education.[9]

The question naturally arises as to what criteria were
applied to determine the composition of this new Chinese
medicine. While in the modern era statistically demonstrated
clinical efficacy is the only universally acceptable criterion,
the science of statistics never developed in traditional China.
There were never large hospitals offering the possibility of
broad clinical trials; there were never computers to manage the
information.[10] The effectiveness of a method of treatment was
judged by how it withstood the test of time. In creating the
new ``traditional'' Chinese medicine, the Chinese selected
theories and methods of treatment that were based on a coherent
rationale and that were revered over centuries. Although they
began to gather statistical data, there is clear evidence that
their choices were, and continue to be, not only technical, but
also political.[11]

Although much older medical literature is available to the
public in China, school curriculum is increasingly based on the
new literature created by China's universities to meet the
exigencies of the modern period. The new literature, for
example, barely mentions the hun, the po, and other ``psychic''
aspects of the organs. Presumably these ideas are thought to
be clinically invalid or to introduce unnecessary elements of
superstition. The new literature also omits mention of many of
the sociopolitical analogies of traditional medicine.
Analogies of the liver as the general, or the lung as the
assistant, have been omitted or minimized because they are
reflections of China's pre-communist society. While the new
literature includes the five phases, it judges the shortcomings
of this theory by reference to marxist theory.[12] The new
Chinese medicine also has provided explanation for the etiology
of diseases that are contained nowhere in the traditional
literature,[13] and has applied traditional drug functions to
acupuncture points in an effort to homogenize the two distinct
traditions.

In transmitting Chinese medicine to the West, our options
for what we present and how we present it are limited. The
older classical literature holds immense difficulties for
translators, and even if good translations of all the classics
were available, they would not be acceptable to Western
students. Imagine, for example, the reaction of the present
generation of Western acupuncture students if the Nan Jing were
given as a first-year text! What was acceptable to Chinese
students in an apprenticeship system, in which books are an
adjunct to practice, does not apply to classrooms in the West,
where theory precedes clinical experience.

The Chinese medicine easiest to present to the West is the
distilled, systematized form devised for the modern classroom.
The Chinese met the West halfway by creating this new Chinese
medicine, then attempted to go further by providing
translations of selected works in English and other European
languages. In selecting texts for presentation to the West,
they chose books based on overviews with minimal detail.
Essentials of Chinese Acupuncture, for example, was translated
from one of the briefest overviews of acupuncture available in
the Chinese language. It is also one of the texts with the
greatest Western medical bias, a fact that suggests that it was
written for medical doctors who wished to inform themselves
about Chinese medicine. This text has since been superseded by
the more detailed and slightly improved Chinese Acupuncture and
Moxibustion. However, this text shares with its predecessor a
stong Western bias and great simplification. In these texts,
scant information is reduced further in translation. Chinese
medical conditions are translated into Western medical
diseases. Non-standard translation methodology obscures subtle
aspects of meaning. Concepts and their renderings are
reoriented; terms are translated inconsistently, breaking the
conceptual unity present in the Chinese editions.

Despite these failings, the English literature produced by
mainland China has become the accepted standard for an attempt
to build an English-speaking profession over the past twenty
years. While in China, the ``rewritten'' Chinese medicine
stands side by side with traditional literature, English-
speaking Westerners have only a partial view of the rewritten
story. What is now understood as Chinese medicine in the West
is considerably simpler than what is practiced in China today,
and is even further removed from the traditional Chinese
medicine practiced before 1950.

The Western translators of clinical literature have endorsed
China's simplification as natural and necessary for a Western
readership, and have accepted it as an adequate basis for a
medical profession. The subject of China's revision is rarely
discussed openly, and there has been relatively little effort
to identify or modify the shortcomings of Chinese
presentations.[14]

The direction taken by Chinese textbooks is understandable.
The Chinese have wrestled with the challenge to traditional
medicine that is presented by the world-wide success of Western
biomedicine. Because biomedicine is based on theories that are
more easily demonstrable by rigorously measured clinical
criteria, Chinese concern has been whether Chinese medicine can
be substantiated by scientific method, and whether it can be
wedded to Western medicine in a comprehensive health care
system. Their decision to translate literature with a strong
Western bias was doubtlessly influenced by a desire to simplify
the translation process and safeguard Chinese medicine's image
in an international community uninitiated to the Chinese view
of the body.[15] It may also be indicative of the assumption
that Westerners share the same desire for scientific
justification. While simpification of data and reference to
the more familiar biomedical context is welcome for beginning
students, failure to present and explain ``raw'' Chinese
medical concepts has negative long-term consequences for the
development of Chinese medicine in the West. A broader, richer
Chinese medicine has a greater chance of acculturation in the
West than a Chinese medicine simplified and Westernized -
especially since the popularity of Chinese medicine in the West
is associated with dissatisfaction with Western medicine.

We believe that in the presentation of Chinese medicine
there is a viable alternative to that embodied in the English
literature thus far generated by official Chinese agencies and
those who have followed their methods. Although it was
probably impossible to escape dependence on modern Chinese
literature to provide an overview of the field during the
initial stages of transmission, the selection of texts and
translation methods that replace Chinese medical concepts with
Western medical concepts or otherwise damage the integrity of
Chinese medicine is neither necessary nor suitable for Western
needs. In our opinion, translation can, and should, be based
on Chinese texts and translation methods that preserve the
original concepts as much as is possible.

We feel that solutions to the problems posed by the
transmission of Chinese medicine are found in Chinese medicine
itself. To preserve the foundations of a holistic medicine we
cannot ignore the culture that produced it. To achieve a
deeper understanding of what we call Chinese medicine, we need
the knowledge of historians, and must accept the help of
anthropologists and epistemologists who can help us achieve a
clear understanding of how those who developed Chinese medicine
conceived of it and used its concepts in the practice of
healing. For those issues that concern the translation of
Chinese medicine for the healing professions in the West, there
is a broad consensus among those who have investigated the
deeply buried roots of China's medical knowledge. By applying
the fruits of that consensus, and the standards of professional
translation, we will gain a better understanding of the origins
of the discipline, and a clearer grasp of its ideas. In so
doing, we will be able to transmit Chinese medicine with
minimum loss.[16]

Many Westerners feel that the English literature from
mainland China represents most of what is useful in Chinese
medicine, and that the concepts found in more comprehensive
Chinese texts are not worth the trouble of understanding. Such
feelings are unconstructive because failure to face the
intellectual challenge of Chinese medicine means that people
will superimpose Western ideas on Chinese concepts.[17]
Inaccuracy in transmission is a far greater impediment to a
deeper understanding of Chinese medicine than is the
transmission of ideas that may, when subjected to closer
clinical scrutiny, prove to be of little or no clinical value.
The barriers to the mastery of Chinese medicine in the West lie
in this reluctance to broach the topic of transmission
difficulty, rather than in any difficulty inherent in the
subject matter itself.

Whatever aspect of Chinese medicine is transmitted, and
whether the source is conversations with Chinese doctors in the
clinic, or the texts available in Chinese, the medium by which
Chinese medicine is taught is language. For centuries the
theory and practice of Chinese medicine have been transmitted
by written records and the communication of daily experience
through spoken language. Chinese physicians possess a
relatively standardized technical vocabulary for the discussion
of medical problems, whether writing or speaking. However, to
date there has been no clear English counterpart for this
clinical language.[18] Thus, in the initial transmission of
Chinese medicine to the West, attention must be paid to
developing a terminology that faithfully reflects Chinese
concepts. The set of terms contained in this glossary is our
proposal for such a terminology.

Western students cannot fail to be aware that Chinese
medicine is presented in different ways and described in
different words. They may infer from this that Chinese
medicine is difficult to translate and that people hold
different views about how the task should be accomplished.
However, translators never speak plainly about the problems
inherent in translations. While it is a tradition in
sinological research to explain Oriental concepts in such great
detail that term choices are implicitly clear, translators of
English language clinical works have only recently begun to
relate some of the terms they use to the original Chinese
characters.[19] Few clinical writers have ever published a
complete Chinese-English list of term choices, or explained the
translation approach they have adopted.[20; *1] As a consequence,
fellow translators are unable to review their work or access
their terminology conveniently. Just as important, students
and practitioners, unable to cross-reference the works of
different writers, have difficulty expanding their knowledge.
Translation in any technical discipline relies on the
existence of bilingual dictionaries. No precise set of
equivalents that can be consistently used can be reliably
applied or communicated to others if it is stored only in the
mind of a human (unless the discipline is extremely simple,
which is rarely the case). At the current time, there are few
translator's dictionaries available. All have been compiled
since World War II, after efforts to integrate Chinese medicine
with Western medicine were already well underway. They so
abound in translation of Chinese medical concepts into Western
medical terms that they have to be consulted with extreme
caution.[21]

Since transmission of a discipline from one culture to
another involves both those who transmit the information and
those who receive it, students and clinicians share with
translators a common concern for how this transmission can best
be accomplished. Greater awareness of the problems posed by
the translation of Chinese medicine will make readers more
discerning judges of what they read, and in the longer term
will encourage the more rigorous application of translation
principles. As readers come to understand the problems of
translation, they will naturally assert their preference for
accurate presentations that deepen their understanding.
Clinicians who do not read Chinese have a right to know what
the problems of translation are and what solutions have been
offered. Until they understand these issues, they will be
dependent on all too few individuals whose work is all too
often closed to scrutiny by students, practitioners, and
experts in related fields. In short, the Chinese medical
community cannot objectively determine the most clinically
viable solutions without an understanding of the problems
associated with the transmission of Chinese medicine.

In the following paragraphs of this introduction, we will
attempt to explain our conception of Chinese medicine and show
how it applies to translation. We will demonstrate how certain
translation practices and trends in term selection contradict
the spirit of Chinese medicine, and therefore retard its
understanding in the West. Although all conceptions of Chinese
medicine are to some extent subjective, failure to state our
assumptions would leave much of our translation rationale
unexplained and open to misinterpretation.

What is being transmitted?

By the beginning of the first millenium, ideas that were to
contribute to Chinese health care for 2,000 years had already
crystallized. The ideas set forth in the Nei4 Jing1 (The
Yellow Emperor's Inner Canon) demonstrated a new realization
that the human body followed predictable patterns, and that its
health was largely a matter of good sense and discipline on the
part of each individual. These ideas embodied a rejection of
the belief prevalent at the time that sickness was caused by
jealous or angry ancestors, or the actions of evil spirits.
Although The Inner Canon speaks of disease-causing influences
from outside the body as ``evils'' (xie2), it sees these as
following an order in nature rather than as capricious demonic
rule. The Inner Canon viewed the individual as able to avoid
these evils by following sensible precautions. Although a
belief in spirits as the cause of disease has remained in China
even to the present day, the view that the body obeyed a
natural order struck a chord in the intellectual elite of
ancient China. It was this literate elite that refined and
developed these ideas over many centuries.[22]

As belief that disease was caused by supernatural forces
gave way to knowledge that it was the outcome of natural
causes, attention shifted from warding off and exorcising
demons to investigating the healthy body and the mechanisms of
disease. The Inner Canon marked a clear start toward a
``rational'' approach to medicine. However, on closer
examination we discover that the reasoning the ancient Chinese
applied was in some respects quite different from the reasoning
inherent to modern Western medicine. The conclusions that the
ancient Chinese reached about the organs of the body, and their
functions, as well as the causes and development of disease,
while bearing some similarity to those of Western medicine,
reveal striking differences. By examining Chinese theory, we
discover features of Chinese medicine that can be understood
not only through comparison but also through contrast to
twentieth-century Western thought.

The basic features of Chinese medicine are heterogeneous.
The theories that have arisen over the centuries contradict
each other. Some are even based on different cognitive
approaches. It has always been a characteristic of the
pragmatic Chinese mind to be able to use theories like tools to
perform different tasks. The Chinese do not regard theory, as
we do in the West, as needing to be forever rewritten to
achieve the highest degree of approximation to a coherent ``Law
of Nature.'' They did not perceive theory as an exclusive means
of reaching a one and only ``Universal Truth.'' The Chinese
doctor can both look at the kidney as a machine and think of it
as a reflection of universal propensities found in nature and
human society. He can apply two different disease
classification systems, cold damage (shang1 han2) or warm
disease (wen1 bing4) where he feels it is appropriate, without
being deterred by contradictions between the two. It is
important to keep this syncretistic bent in mind if we are to
understand the Chinese view of health and sickness.

It is of crucial importance for Western readers to take a
cool-headed look at the questions: What is Chinese medicine?,
What are its underlying features?, and What is the mind that
created it? It cannot be over-emphasized that there is a
mistaken belief prevalent in the West that Chinese medicine is
completely different from Western medicine,[23] and hence a
good alternative, when, in fact, of all the health care
practices in China, the West has singled out those (acupuncture
and herbology) that come nearest to its own conception of
medicine. There is more than a grain of truth in the
generalization that Westerners, like most cultural groups,
imagine themselves to want something different from what their
own civilization offers, but, at a deeper level of their belief
structure, they can accept only what is fundamentally the same.

Basic analysis

One method of gaining knowledge is analysis - the method of
breaking things into component parts to understand the whole.
This method has been applied in China, but nowhere and at no
time has it reached such sophistication as in Western
civilization since the Renaissance. Analysis is one of the
salient features of all modern science and technology. Indeed,
far more importantly, it has become so deeply entrenched in our
day-to-day thought that it is an integral part of the Western
mindset and indissociable from what we call ``reason.''

The analytical approach is the very foundation of modern
medicine. Once Western investigators had identified all the
organs of the body, they started to break each of them into
component parts and determine what functions each of the parts
performed. Having discovered the stomach, they proceeded to
investigate its structure and analyze the composition of the
chemicals passing through it. They determined that in its
mucous lining are glands that secrete into the cavity of the
stomach a gastric juice containing hydrochloric acid, pepsin,
and various digestive enzymes. They learned that food mixed
with this secretion to form a semifluid substance (chyme) from
which the intestine absorbs water, electrolytes, and nutrients.
These discoveries could not have been made without instruments
and testing procedures, since these glands, enzymes, and
electrolytes are undetectable by the naked senses. The process
of splitting things into ever smaller parts requires tools to
see what is too small for the naked eye. The invention of the
microscope brought into view a whole world to which the naked
eye was blind, while biochemical testing forced otherwise blank
and unrevealing matter to yield its secrets.

Allied to the notion of analysis in the Western sciences are
the technique of quantification and the idea of causality.
Physiologic function in Western medicine is determined by the
ability of organs to produce measurable increases or reductions
in substances. Indeed, those substances are seen, at least
partly, in quantifiable terms. Water is viewed as two atoms of
hydrogen attached to one atom of oxygen, and the quality of
liquidity is thought of as the binding power between those
atoms. Analysis also naturally tends to focus on causal
relationships. By determining precisely what functions are
performed by what entities, analysis strives to identify what
is caused by what. The notion of cause and effect is thus
implicit in the analytic approach. The form and quality of
water, for example, are seen as a subjective ``illusion''
caused by partially quantifiable factors determined by
analysis.

Analysis is far less important to Chinese medicine than to
Western sciences. The ancient Chinese did apply analysis in
their investigation of the human body, but to a lesser degree.
Hazy though the origins of Chinese medicine are, we can be sure
that analysis provided some important insights into the
workings of the human body. It is obvious that certain
functions ascribed to the organs were suggested by the form and
contents of the organs themselves. The ancient Chinese knew,
for example, that the stomach and intestines were organs of
digestion, and that the lung drew air from the environment.
They knew that the kidney produced urine, which was stored in
the bladder ready for discharge. They also knew that the heart
was connected to the blood vessels, and that the liver stored
blood. Statements in The Inner Canon concerning the dimensions
and capacity of the organs mean that the ancient Chinese must
have performed rudimentary dissections that led to these
discoveries.[24]

It is important to emphasize that the origins of China's
medical knowledge are a matter of speculation rather than
certainty. The ancient Chinese did not actually state how they
arrived at their conclusions. The best we can do is to make
reasoned guesses on the basis of the earliest statements. What
seems to be clear from the assertions in The Inner Canon is
that, while some rudimentary discoveries about the organs were
made by the method of analysis, many, if not most, theories
cannot be explained by this approach. It would appear that,
when dissection revealed nothing further to the naked senses,
the analytical approach was abandoned in the absence of the
instruments needed to pursue it, and another approach was
adopted in its stead.

Naked sense observation and relationships

Without microscopes and testing devices, what could the
ancient Chinese hope to understand about the body? The answer
is simple: they observed phenomena very closely, and
identified relationships and patterns. Instead of breaking a
thing apart to determine its composition or analyzing an event
to see how it arose, they compared and contrasted gross
phenomena, and saw how they related to each other. Rather than
making from their observations complex deductions that required
analytical proof, they confined themselves to simple
inferences.[25]

This point is well illustrated by ``qi,'' an entity that
Westerners find hard to conceptualize, since it does not fit
any known scientific category. Unless we wish to dismiss the
concept as fanciful, it is clear that if qi was observed by the
ancient Chinese, the only way it could be was by the naked
senses. If we apply a little imagination to how it was
observed, we will have a better grasp of both the concept and
the way in which the Chinese pursued their investigations.

The ancient Chinese could see, for example, that when we are
healthy, food is carried down the alimentary canal. They also
noted that vomiting involves a rising movement that ejects food
from the stomach, and is accompanied by sensations of heaving.
They perceived this activity in terms of two movements: a